"The Hilo residency program is designed to train physicians who can care for patients during their residency program, and also, we anticipate a number of them will choose to stay in the area or in the state," said medical center CEO Howard Ainsley.

The state Legislature failed to allocate funds for the program and hospital administrators anticipate expenses of more than $1.2 million in the coming fiscal year, leaving a shortfall of more than $500,000.

The program has long had funding problems. In 2008, $4 million in state funding was withheld. A fundraising campaign provided $1.5 million to launch the program's clinic in 2009.

There is a shortage of about 50 primary-care physicians on the Big Island, according to a University of Hawaii John A. Burns School of Medicine study. East Hawaii alone needs 14 additional primary-care doctors.

"Given the shortage, many primary-care physicians are not accepting new patients," Ainsley said. "For many people, this means long waits to get an appointment."